For Postpartum Hemorrhage, Carbetocin Similar to Oxytocin

(HealthDay News) — For women after vaginal birth, heat-stable carbetocin is non-inferior to oxytocin for prevention of blood loss of at least 500 ml or use of additional uterotonic agents, according to a study published online June 27 in the New England Journal of Medicine.

Mariana Widmer, from the World Health Organization in Geneva, and colleagues enrolled women across 23 sites in 10 countries in a non-inferiority trial comparing intramuscular injections of heat-stable carbetocin with oxytocin administered immediately after vaginal birth. A total of 29,645 women were randomized.

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The researchers found that the frequency of blood loss of at least 500 ml or the use of additional uterotonic agents was 14.5 and 14.4 percent in the carbetocin and oxytocin groups, respectively (relative risk, 1.01; 95 percent confidence interval, 0.95 to 1.06), which was consistent with non-inferiority. The frequency of blood loss of at least 1,000 ml was 1.51 and 1.45 percent in the carbetocin and oxytocin groups, respectively (relative risk, 1.04; 95 percent confidence interval, 0.87 to 1.25), with the confidence interval crossing the non-inferiority margin. There was no significant difference between the groups in terms of use of additional uterotonic agents, interventions to stop bleeding, and adverse effects.

“Heat-stable carbetocin was non-inferior to oxytocin for the prevention of blood loss of at least 500 ml or the use of additional uterotonic agents,” the authors write.